Publicly Insured and Uninsured Patients are More Likely Than Other Patients to be Treated Unfairly in Healthcare Settings Because of Their Coverage Type

A man and woman sign in at a polling center for flu vaccinations.

Individuals without insurance and those with public coverage like Medicaid report being treated unfairly in healthcare settings at higher rates than individuals with private insurance.

The Issue

Unfair treatment of judgment in clinical settings can often lead to adverse health effects, included delayed or foregone care and not following a clinician's recommendation. 

Key Findings

  • Nearly one in 10 adults with public health coverage (9.6%) reported experiencing unfair treatment or judgment in a clinical setting because of their insurance status. 

  • Only 1.3 percent of adults with private insurance reported unfair treatment of judgment.

  • Adults with public coverage were about 1.5 times more likely to report insurance-related hassles than those with private coverage (16.2% versus 11%). 

  • When examining unfair treatment or judgment in a clinical setting due to race or ethnicity, researchers found that patients reported unfair treatment or judgment from clinical providers and front office staff at nearly equal rates.


Understanding who is experiencing unfair treatment in clinical settings can aid health professionals and policymakers alike as they work to implement effective solutions to prevent unfair treatment. 

About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.